| Sunrise Medical Management Llc | |
|
13634 N. 93rd Ave #100 Peoria AZ 85381 | |
| (623) 933-0301 | |
| (623) 933-0224 |
| Full Name | Sunrise Medical Management Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13634 N. 93rd Ave, Peoria, Arizona |
| Authorized Official Name and Position | Girish H Mehta (PRESIDENT) |
| Authorized Official Contact | 6239330301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Medical Management Llc 13634 N 93rd Ave #100 Peoria AZ 85381 Ph: (623) 933-0301 | Sunrise Medical Management Llc 13634 N. 93rd Ave #100 Peoria AZ 85381 Ph: (623) 933-0301 |
| NPI Number | 1326161548 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 03/04/2021 |
| Medicare PECOS PAC ID | 4880586437 |
|---|---|
| Medicare Enrollment ID | O20040327000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326161548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 22557 (Arizona) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | 18499 (Arizona) | Primary |
| Provider Name | Shannon P Valenzuela |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134118995 PECOS PAC ID: 9931097482 Enrollment ID: I20040308000456 |
| Provider Name | Raj K Mulpuri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669460853 PECOS PAC ID: 8224016514 Enrollment ID: I20040713000168 |
| Provider Name | Khaleel Salahudeen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1811975089 PECOS PAC ID: 2466424643 Enrollment ID: I20060306000087 |
| Provider Name | Girish H Mehta |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508854787 PECOS PAC ID: 2668389396 Enrollment ID: I20061110000341 |
| Provider Name | Shahid Yakoob |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386656049 PECOS PAC ID: 9830119486 Enrollment ID: I20090102000041 |
| Provider Name | Todd Hrabak |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1801821152 PECOS PAC ID: 2961550769 Enrollment ID: I20090505000448 |
| Provider Name | Gagandip B Singh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801127568 PECOS PAC ID: 8325180888 Enrollment ID: I20101014000245 |
| Provider Name | Amit Dhingra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437122397 PECOS PAC ID: 8224090279 Enrollment ID: I20110831000081 |
| Provider Name | Adam Bosak |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710115423 PECOS PAC ID: 8729229471 Enrollment ID: I20130723000969 |
| Provider Name | Chelsea Bosak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720674732 PECOS PAC ID: 3870909369 Enrollment ID: I20210308002494 |
| Provider Name | Thomas W Pollard |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710069885 PECOS PAC ID: 5698766228 Enrollment ID: I20210322001685 |
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